Lesbians Sexual Health & Pap Smears It is important to look after your sexual health and well-being. This brochure dispels some of the myths , around lesbians sexual health and discusses the importance of having regular Pap smears. 2 Lesbians and sexually transmitted infections (STIs) It is a myth that lesbians are not at risk of STIs. There are cases of women transmitting Human Immunodeficiency Virus (HIV), human papillomavirus (HPV), herpes and syphilis to other women. In theory, women could also transmit chlamydia and gonorrhoea to other women. The vaginal infection bacterial vaginosis (BV) is more common among lesbian women. It is still not certain if BV is transmitted through sex. If left undetected, STIs can lead to serious complications such as pelvic inflammatory disease, ectopic pregnancy and infertility. Other infections that can be sexually transmitted include hepatitis A, B and rarely C. The risk of transmission of various infections is dependent on specific sexual practices and other behaviours such as sharing sex toys or injecting equipment. Therefore, it is important to find a health professional with whom you feel comfortable talking to about your risks and whether you should consider having tests for STIs. 3 Safer sex practices When you enter a new sexual relationship talk to your partner about who they have had sex with in the past. This can help you find out if you may be at risk of contracting a STI. Talking honestly can also give you the chance to discuss what sexual practices you prefer. You can reduce your risk of contracting a STI by: • Using dams during oral/vaginal and oral/anal sex • Using latex gloves and water based lubricant when touching/penetrating the vagina/anus • Using condoms and water based lubricant when sharing vibrators, dildos and other sex aids • Having a sexual health check when starting a new relationship • Asking a new partner to have a sexual health check. You can have a sexual health check at your doctor’s surgery, sexual health clinic or family planning clinic. 4 Whatdams?are Dams are thin latex sheets that go over the vaginal or anal area to act as a barrier during oral/vaginal or oral/anal sex. Using dams: • Do not reuse or share dams • Use one side of a dam • Use a new dam if switching between oral/vaginal and oral/anal sex • Use a water-based lubricant on the underside of the dam to increase sensitivity • Store dams in a cool, dry place away from direct sunlight. Dams come in a variety of colours and flavours and can be obtained from chemists and sexual health and family planning clinics. If dams are unavailable an unlubricated condom or latex glove can be cut up and used. 5 Cervical cancer Approximately 230 women die of cervical cancer in Australia every year. The cervix is the entrance to the uterus or womb. Up to 90% of cervical cancer cases could be prevented if women had a Pap smear every two years. There are a number of risk factors for cervical cancer: • Human Papillomavirus (HPV): This virus is very common and there are many different strains. Some are sexually transmitted and can infect the genital area (genital HPV). Genital HPV is transmitted through skin to skin contact of the genital area. Certain strains of genital HPV are linked to abnormal cell changes in the cervix. In most cases these changes will disappear naturally in about 8-14 months. If they persist, however, they can develop into cervical cancer. A vaccine is now available for some types of genital HPV. As it does not provide protection from all strains of genital HPV that cause cervical cancer, regular Pap smears are still required for vaccinated women. • Smoking: Smoking significantly increases a woman’s risk (up to four times that of non-smokers). • Not having regular Pap smears: Three out of four women who develop cervical cancer have never had a Pap smear or do not have regular two yearly Pap smears. 6 Wpaphatsmear? is a A Pap smear is a screening test that detects early changes in cells of the cervix. Cervical cancer can usually be prevented if these changes are found and monitored until they disappear naturally or are treated. A Pap smear is conducted by a health professional (usually a doctor or nurse). It involves: • Placing an instrument called a speculum into the vagina so the cervix can be clearly seen • Cells are wiped from the cervix using a small spatula and/or brush • Cells are smeared on a slide and sent to a laboratory for testing. Wpaphatsmear is the register? The register keeps a confidential history of your Pap smear results and sends you a reminder if you are overdue for your next smear. Results of your smear are automatically sent to the register. If you do not wish to have your details forwarded to the register you can tell your health professional at the time of the smear. For further information contact: 1800 777 790. 7 Lesbians and pap smears Lesbians are less likely to have had regular Pap smears. This may be due to: • A personal belief that there is no risk of STIs and cervical cancer • Not being able to afford it • Being told by health professionals that lesbians don’t need Pap smears • Not routinely visiting a health professional for other reasons (eg. for contraception) • Difficulties finding a suitable health professional • Previous experience of homophobia or fear of homophobia. Early changes in the cervix that can progress into cervical cancer have been found in lesbians. Current national recommendations are that all women aged between 18 and 70 who have ever had sex need to have a Pap smear every two years. Women who have received the cervical cancer vaccine still need to have regular Pap smears. Whilst the risk of cervical cancer for women who have only ever had sex with women is uncertain, it is advisable to discuss with a health professional knowledgeable in the area of sexual health whether you are at risk of cervical cancer and should consider having a Pap smear. If you experience symptoms like bleeding between periods, after menopause or following sexual activity or abnormal discharge you should see a health professional, even if your previous Pap smear result was normal. 8 Finding a health professional A health professional who understands your health issues as a lesbian is important. To find someone suitable you can: • Ask friends • Look for advertisements in the gay and lesbian press • Contact the organisations listed on the back of this brochure. If you have had a negative experience with a health professional you can make a complaint to the Health Quality and Complaints Commission. The AntiDiscrimination Commission Queensland can also be contacted for discrimination issues. 9 For more information: Women’s Health Queensland Wide - Health Information Line (07) 3839 9988 1800 017 676 (toll free outside Brisbane) www.womhealth.org.au Family Planning Queensland (07) 3250 0240 www.fpq.com.au Queensland Health - Sexual Healthline (07) 3240 5881 www.health.qld.gov.au/sexhealth/ Gay and Lesbian Welfare Association Counselling and referral, 7pm-10pm - (07) 3017 1717 1800 184 527 (toll free outside Brisbane) www.glwa.org.au Open Doors (supports lesbian, gay, bisexual and transgender young people and their families) (07) 3257 7660 www.opendoors.net.au Health Quality and Complaints Commission (07) 3120 5999 1800 077 308 (toll free outside Brisbane) www.hqcc.qld.gov.au Anti-Discrimination Commission Queensland 1300 130 670 www.adcq.qld.gov.au Queensland Health Pap Smear Register 1800 777 790 10 This brochure was jointly developed by: Women’s Health Queensland Wide PO Box 665 Spring Hill Q 4004 Telephone: (07) 3839 9962 Email: [email protected] Web: www.womhealth.org.au Family Planning Queensland 100 Alfred Street PO Box 215 Fortitude Valley Q 4006 Telephone: (07) 3250 0240 Email: [email protected] Web: www.fpq.com.au Women’s Health Queensland Wide Inc. and Family Planning Queensland have made every effort to ensure this information is accurate. However, they accept no responsibility for any errors, omissions or inaccuracies in respect of the information contained in the material provided by Women’s Health Queensland Wide Inc. and Family Planning Queensland nor is the provision of the material by Women’s Health Queensland Wide Inc. and Family Planning Queensland to be construed as any representation that there are no other materials or information available in relation to the information provided. Further, Women’s Health Queensland Wide Inc. and Family Planning Queensland accept no responsibility to persons who may rely upon this information for whatever purpose. ©Women’s Health Queensland Wide Inc. and Family Planning Queensland June 2009